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November is “Antimicrobial Resistance (AMR) Awareness Month” in Japan, and November 18 to 24 is designated as “World Antimicrobial Awareness Week.”
AMR occurs when bacteria, viruses, fungi, and parasites change over time and become unresponsive to medications, making it more difficult to treat infections and increasing the risk of disease spread, severity, and death. Owing to AMR, antibiotics and other antimicrobials become ineffective, making the treatment of infectious diseases increasingly difficult or impossible. The World Antimicrobial Awareness Week is a campaign based on a global action plan to address the growing problem of resistance to antibiotics and other antimicrobials.
Japan has also designated the month of November as “AMR Countermeasure Promotion Month” to promote nationwide awareness-raising activities related to the globally threatening AMR problem.
In conjunction with this global and Japanese campaign against AMR, CareNet conducted a survey of 203 of its physician members who treat infectious diseases, including general internal medicine and otorhinolaryngology, who deal with upper respiratory tract infections, regarding their awareness of antimicrobial treatment. The results revealed the following points:
<Survey period>10/9/2023 – 10/16/2023
・It is clear that more than 90% of physicians are aware of AMR in their daily practice and treatment.
・The annual prescription of antimicrobials to patients with the common cold who have upper respiratory tract symptoms without underlying diseases has been on a decreasing trend. Regarding whether they explained the reason for not prescribing antimicrobials for the common cold, 37.9% said “every time” and 49.3% said “sometimes explain but not always.”
・The percentage of patients diagnosed with the common cold and their families requesting antibiotic prescriptions was not high. However, if a patient or family member requests an antibiotics prescription, nearly 70% of doctors say they will prescribe antibiotics, including cases in which the patient or family is not convinced, even after explaining that they are not indicated. This finding suggests the need to continue educating patients about AMR.
・Regarding antibacterial agents and drug resistance, physicians felt that they lacked tools to educate patients not only on how to use antibacterial agents but also about their proper use. This result highlights the issues on the part of patients.
【Key Findings】
Regarding the question, “To what extent are you aware of AMR in your daily practice,” 25.6% said they were “always aware” and 32.0% said they were “fairly aware,” indicating that nearly 60% of physicians were highly aware of AMR. When combined with the 33.5% who were “somewhat aware,” it became clear that more than 90% of physicians were aware of AMR in their practice and treatment.
[Table 1]
In the question, “In the past year, if a patient with upper respiratory tract symptoms without an underlying disease was seen and diagnosed with the common cold, at what rate did you prescribe antimicrobials?”, 83.7% of respondents answered “0~20%” including 34.9% of “0%,” while “21~40 %” were 6.9%, indicating a decreasing trend in the prescription of antimicrobials for the common cold.
(Answer between 0-100%, with patients diagnosed with a cold as 100%.)
[Table 2]
When asked whether or not they explained the reason for not prescribing antimicrobials, 37.9% said “every time” and 49.3% said “sometimes explain but not always.”
[Table 3]
When asked about the “percentage of patients and their family members who wanted antimicrobial prescriptions for patients diagnosed with the common cold,” the most common response was “0~20%” (56.7%), followed by “21~40%” (20.7%).
[Table 4]
When asked, “How would you respond if a patient diagnosed with the common cold and their family request an antimicrobial prescription?”, 10.3% responded “prescribe antibiotics as requested” and 59.1% responded “prescribe antibiotics if explanation is not accepted,” indicating that nearly 70% of respondents would prescribe antibiotics in such cases. This finding suggests the need to continue educating patients about AMR.
[Table 5]
In the question, “What do you think are the issues regarding antimicrobial agents and drug resistance? (multiple answers),” 56% of the respondents answered, “Lack of education on the use of antimicrobial agents among patients,” followed by 37% who answered, “Lack of tools to promote proper use among patients.” This result highlighted patients’ issues related to their awareness of antimicrobial treatment.
In addition, 25% of respondents answered, “Problems with supply/distribution system such as insufficient supply and stock,” and 15% answered, “Lack of drugs to deal with many types of resistant bacteria.” There are also issues on the drug side, such as problems related to access to existing therapeutic drugs and the need to develop new antibiotics.
[Table 6]
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